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University Orthopaedics, Hand

and Reconstructive Microsurgery Cluster

Ankle Conditions

 

Doctors 

 

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What causes ankle pain?

Arthritis

Although Arthritis causing ankle pain is not as common compared to the degenerative changes in other joints, it can be quite painful. Ankle Arthritis is most common in patients with rheumatoid arthritis or patients with a previous ankle injury.

Sprains

A sprain in the ankle causes an injury to the ligaments around the ankle. Such injuries can cause pain and swelling. In addition, the patients may feel as though the joint may give way.

Tendonitis

A patient has tendonitis when the tendons become irritated and inflamed.

Posterior Tibial Tendonitis

If left untreated, posterior tibial tendonitis, which causes ankle pain on the inside part of the joint, can lead to significant walking problems.

Achilles Tendonitis

This is the most common type of tendonitis around the ankle joint and causes pain over the back of the heel.

Fractures

There are many different types of ankle fractures and each must be treated differently. While some ankle fractures can be treated like sprains, others may require surgery.

Gout

Gout is a relatively uncommon cause of ankle pain.

Cartilage Damage

The cartilage of the ankle joint is susceptible to injuries if ankle sprains, fractures or other ankle injuries are left untreated.

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When do you need to consult your doctor about your ankle pain?


Patients are advised to seek medical attention if you are unsure of the cause of your symptoms.  You should consult your doctor if you have the following symptoms:

 

  • Unable to walk comfortably on the affected side
  • Have an injury that causes deformity around the joint
  • Ankle pain occurs at night or while you are resting
  • Ankle pain that persists beyond a few days
  • Unable to bend the ankle
  • There is swelling of the joint at the calf area
  • There are signs of an infection, including fever, redness, warmth
  • Any other unusual symptoms

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Treatment options

The treatment depends entirely on the cause of the problem. Therefore, it is important that you understand the cause of your symptoms before embarking on a treatment programme. If you are unsure of your diagnosis, or the severity of your condition, you should seek medical advice before beginning any treatment plan.

 

Rest

This is usually the first treatment for most common conditions to relief ankle pain as it allows the inflammation to subside. Crutches may be helpful if the symptoms are severe.

Footwear Modifications, Orthotics and Braces

This form of treatment may be helpful depending in the specific injury to be addressed.

Ice and Heat Application

Ice packs and heat pads are among the most commonly used treatments for inflammation.  Ice packs are mostly used for acute injuries to help minimise swelling while heat pads are used for chronic conditions to help relax and loosen tissues, and to stimulate blood flow to the area.

Stretching

Stretching the muscles and tendons that surround the joint can help with some causes of ankle pain. A good routine should be established.

Physiotherapy

Physiotherapy is an important aspect of treatment for almost all orthopaedic conditions. Physiotherapists use different modalities to increase strength, regain mobility, and help return patients to their pre-injury level of activity.

Anti-Inflammatory Medication

Nonsteroidal anti-inflammatory medications, commonly referred to as NSAIDs, are some of the most frequently prescribed medications, especially for patients with ankle pain caused by problems such as arthritis, bursitis, and tendonitis.

Steriod Injections

Triamcinolone is a powerful medication that treats inflammation, and inflammation is a common problem in patients with ankle pain.

 

Surgery

Surgery is rarely used as part of the acute treatment of an ankle sprain. Patients who undergo surgery usually have recurrent ankle injuries and persistent ankle pain. This could be that they have ligaments that were torn and did not heal properly.

Patients who have chronic, recurring ankle sprains usually have loose ligaments. The most commonly performed surgery to ‘tighten’ these ligaments is called a Brostrom repair. During the surgery, the ligaments on the outside of the ankle are tightened, preventing the ankle from being unstable.

An unstable ankle joint can be detected via a physical examination where the doctor will compare the ‘good’ ankle with the injured ankle to get an idea of how ‘loose’ the injured ankle is. A X-ray of the ankle can also be taken to see if the bones are held together tightly enough.

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